Chamber and committees

The one-year guarantee scheme administered by NHS Education for Scotland was set up to find a place in the NHS for newly qualified nurses and midwives who had failed to find a post through the normal recruitment process. Twenty-two nurses and midwives entered the scheme and were referred to NHS trusts with appropriate vacancies. Had the newly qualified nurses and midwives failed to find employment they would have re-entered the scheme but none have done so.

The Nursing and Midwifery Council have set advisory standards for the preparation of mentors who support, educate and assess student nurses and midwives in practice placements. All higher education institutions run in-house mentorship preparation programmes to meet these advisory standards and the demands of their own pre-registration programme. All mentors are required to complete one of these programmes prior to becoming a mentor of students. This ensures a degree of consistency for both nurses and students.The placement of students within NHS board areas is organised by higher education institutions in close partnership with their local trusts. Decisions about number of students in each placement are therefore made locally and subject to negotiation. All these partnerships are trying to ensure maximum use of placements, including in remote and rural areas.A report to be published by NHS Education on 20 March will describe a national approach to the identification and allocation of practice placements in conjunction with ISD. This will reduce the consistency of usage of practice placements, although still taking into account local needs and demands.

Information about the medicinal use of botox is contained in the Botox Summary of Product Characteristics (SPC). The Botox SPC includes a report of peripheral neuropathy in a patient after receiving four sets of botox injections over an 11-week period.

The Deputy Chief Medical Officer wrote to health professionals in NHS Scotland on 14 January 2003 to confirm that parents are entitled to know if thiomersal is contained in the diphtheria, tetanus and whooping cough vaccine available to them, the reasons for this, and the facts about safety and efficacy. The letter also provided various research references to help discuss these matters with patients. The Scottish Centre for Infection and Environmental Health (SCIEH) has placed on its website - www.show.scot.nhs.uk/scieh/ - its review of evidence relating to toxicity of ethyl mercury relating to vaccination.Latest advice from both the UK Committee on Safety of Medicines and the World Health Organisation's Global Advisory Committee on Vaccine Safety makes clear that there is no evidence of toxicity in infants, children or adults exposed to thiomersal (containing ethyl mercury) in vaccines. The committees advise that there is no reason on grounds of safety to change current immunisation practices with thiomersal-containing vaccines. The risk of death and complications from vaccine-preventable diseases is real, compared with the theoretical risk from side effects of thiomersal.The vaccine protects against three life-threatening diseases. Benefits of protection far outweigh any risks due to known side-effects and hypersensitivity.

The Executive has set up Direct Payments Scotland (DPS) to work closely with local authorities and local support organisations to help them set up direct payment schemes in their areas. This work involves increasing local awareness of direct payments and providing support and information as well as identifying and addressing local training needs. The DPS project has now been extended until March 2006 with £285,000 and £210,000 allocated in 2003-04 and 2004-05 respectively and a provisional grant of £150,000 for 2005-06.

All local authority and NHS Partnerships are implementing their Local Joint Action Plans to reach their targeted reductions by 15 April, the final measuring point for 2002-03. Any failure to meet these targets will be reviewed with the partnership concerned before any decisions are made on actions, including the need to introduce support teams. Funding and targets have been provided to partnerships, not to individual local authorities or NHS boards, and we expect partnerships to take responsibility for them. We expect all partnerships to continue to make every effort to meet their performance targets.

Information on the total number of patients aged over 65 in NHS hospitals awaiting placement in a care home is shown in table 1. The figures relate to 15 October 2002, the latest date for which information is centrally available.Table 1: Patients Ready for Discharge - Numbers Waiting for a Care Home Placement¹ Aged 65+, by NHS Trust, as at 15 October 2002

NHS Trust		Number of Patients Ready for Discharge Waiting for a Care Home Placement Aged 65+
Scotland		1,346
Argyll and Clyde
Argyll and Clyde Acute Hospitals NHS Trust		23
Lomond and Argyll Primary Care NHS Trust		27
Renfrewshire and Inverclyde Primary Care NHS Trust		142
Ayrshire and Arran
Ayrshire and Arran Acute Hospitals NHS Trust		28
Ayrshire and Arran Primary Care NHS Trust		63
Ayrshire and Arran (other)		20
Borders
Borders General Hospital NHS Trust		-
Borders Primary Care NHS Trust		30
Dumfries and Galloway
Dumfries and Galloway Health Board		-
Dumfries and Galloway Primary Care NHS Trust		5
Fife
Fife Acute Hospitals NHS Trust		14
Fife Primary Care NHS Trust		74
Forth Valley
Forth Valley Acute Hospitals NHS Trust		7
Forth Valley Primary Care NHS Trust		48
Grampian
Grampian University Hospitals NHS Trust		31
Grampian Primary Care NHS Trust		168
Greater Glasgow
South Glasgow University Hospitals NHS Trust		58
North Glasgow University Hospitals NHS Trust		122
Greater Glasgow Primary Care NHS Trust		21
Highland
Highland Acute Hospitals NHS Trust		22
Highland Primary Care NHS Trust		23
Lanarkshire
Lanarkshire Acute Hospitals NHS Trust		15
Lanarkshire Primary Care NHS Trust		52
Lanarkshire (other)		4
Lothian
Lothian University Hospitals NHS Trust		57
Lothian Primary Care NHS Trust		133
West Lothian Health care NHS Trust		9
Orkney
Orkney Health Board Unit		10
Tayside
Tayside University Hospitals NHS Trust		22
Tayside Primary Care NHS Trust		95
Western Isles
Western Isles Health Unit		23

Note:1. Number of patients ready for discharge where the principal reason was either: - In the categories non-availability of public funding to purchase Residential/Nursing Home Place.Or principal reason was awaiting place availability (no additional detail), - awaiting place availability in local authority residential home, - awaiting place availability in independent residential home, - awaiting place availability in nursing home (not NHS funded), - awaiting completion of social care arrangements in local authority residential home placement, - awaiting completion of social care arrangements in independent residential home placement, - awaiting completion of social care arrangements in nursing home placement (not NHS funded), - patient exercising statutory right of choice with one of the above principal reasons as the secondary reason.Principal reasons excluded are: - awaiting completion of social care arrangements (no additional detail), - patient/carer/family-related reasons - Other (no additional detail).Figures given are day one census figuresThe term "other" refers to beds in non-NHS facilities contracted for NHS use.

Prescription Only Medicines (POMs), like Botox, are on the whole prescribed for individuals by a medical practitioner to be administered by the individual or to that individual by a third party who might be a nurse, carer, relative or other "lay" person. In the latter case, the doctor must be content that the third party is competent to fulfil this role. Botox is licensed for use in the UK for certain purposes, although not for cosmetic purposes. It is, however, not uncommon for drugs licensed in the UK, to be used outwith their market authorisation i.e. licensed uses. In such instances, however, the doctor providing or prescribing the medicine bears a greater degree of medico-legal responsibility for such action.

Under section 172 of the Water Act 1989, the Scottish ministers' may grant indemnities to Scottish Water in respect of:liabilities incurred by Scottish Water in connection with anything done by them to increase fluoride in water supplied;costs or expenses incurred by Scottish Water (or for which Scottish Water is liable) in connection with proceedings brought with respect to things done for the purpose of increasing the fluoride content of any water, or a proposal to do so, andexpenditure incurred by Scottish Water in complying with an order made in any such proceedings.As with any other discretionary power, it would be for the Scottish ministers to determine, having regard to the particular circumstances of the case, whether to exercise the power and, if so, to what extent.

I have been advised by the Food Standards Agency that the directive will not immediately outlaw any products already on the UK market. Its future impact on consumer choice and on businesses will depend on developments on additions to the permitted lists of vitamin and mineral sources and establishment of maximum limits for vitamins and minerals.The Executive intends to take full advantage of the provision in the directive which enables member states to allow, subject to certain criteria being met, the continued sale of products containing vitamin and mineral sources not yet on the permitted lists up until 31 December 2009. The Food Standards Agency continues to press the case for maximum limits to be set at levels which protect public health but do not necessarily restrict consumer choice.